We talk endlessly about low testosterone in men, and almost never about it in women, even though women need testosterone too and can absolutely run low. The result is that a lot of women spend years feeling flat, tired and uninterested in sex, without anyone connecting it to this one small-but-mighty hormone. Let's give it the attention it deserves.

The symptoms of low testosterone in women

Because testosterone supports libido, energy, mood, muscle and cognition, low levels tend to show up across all of those areas. The most common signs:

Low sex drive is the most recognised symptom, often a noticeable drop in desire or sexual satisfaction. Alongside it, women frequently report persistent fatigue or low energy, low mood or a reduced sense of wellbeing, difficulty concentrating or brain fog, and loss of muscle strength. Over the longer term, low testosterone may also contribute to weaker bones.

Sources: Low Testosterone in Women — Cleveland Clinic; Symptoms of Low Testosterone in Women — Cleveland Clinic. Low testosterone can affect libido, mood, energy and musculoskeletal health.

One honest caveat: every one of these symptoms overlaps with other things — thyroid problems, anaemia, stress, depression, poor sleep. That's exactly why low testosterone can't be self-diagnosed and needs a blood test, which we come to below.

What are the symptoms of low testosterone in women?
Common symptoms of low testosterone in women include low sex drive, persistent fatigue or low energy, low mood or a reduced sense of wellbeing, difficulty concentrating or brain fog, loss of muscle strength, and sometimes weaker bones over time. Because these symptoms overlap with many other conditions, low testosterone can only be confirmed with a blood test interpreted by a doctor.

The side effects of low testosterone — on body and mind

When people search "side effects of low testosterone in women," they usually mean: how does it actually affect me? The biggest impacts cluster around sexual health and mental wellbeing. Reduced libido and sexual satisfaction are the most studied. But the emotional toll is just as real: low mood, anxiety, and a dimmed sense of wellbeing are common, and understandably affect quality of life. Over time, lower testosterone can also play a part in reduced muscle mass and bone density, which matters for long-term strength and health.

Source: Low Testosterone in Women: Symptoms, Causes, and Treatment — HealthCentral. Low testosterone in women can cause loss of libido, fatigue and other quality-of-life effects.

Low testosterone in women is real, and so is its toll: on desire, energy, mood and strength. It's not "all in your head," and you're allowed to take it seriously.
What are the side effects of low testosterone in women?
The main effects of low testosterone in women relate to sexual health and mental wellbeing, including reduced libido and sexual satisfaction, low mood, anxiety and reduced sense of wellbeing. Over time, low levels may also contribute to reduced muscle mass and bone density. These effects can meaningfully affect quality of life, which is why low testosterone is increasingly recognised even though it is still underdiagnosed in women.

What causes low testosterone in women

Several things can lower testosterone. The most universal is simply age — testosterone declines gradually throughout adult life, so midlife levels are naturally lower than in your twenties. Beyond age, common causes include:

Ovaries removed or damaged (since the ovaries are a key production site), for example through surgery or chemotherapy. Adrenal or pituitary gland problems, which interfere with hormone production. And certain medications — notably oral contraceptives and oral estrogen therapy (which raise a protein called SHBG that binds testosterone, lowering the active amount), and corticosteroids. Finally, hypothalamic amenorrhea — the loss of periods from extreme stress, significant weight loss or over-exercising — and eating disorders can suppress testosterone too.

Source: Low Testosterone In Women: Causes, Symptoms & Treatment — Cleveland Clinic. Causes include age, oophorectomy, adrenal/pituitary issues, and medications like contraceptives, oral estrogen and corticosteroids.

A note for anyone who recognises the over-exercise or under-eating pattern: losing your period from intense training or restriction (sometimes part of "RED-S" or hypothalamic amenorrhea) is a meaningful signal that your body is under-fuelled, and it affects many hormones, not just testosterone. It's well worth a conversation with a doctor, gently and without judgement.
What causes low testosterone in women?
Testosterone naturally declines with age, but it can also be lowered by having the ovaries removed or damaged (for example by surgery or chemotherapy), adrenal or pituitary gland problems, and certain medications including oral contraceptives, oral estrogen therapy and corticosteroids. Conditions like hypothalamic amenorrhea from extreme stress, weight loss or over-exercise, and eating disorders, can also reduce testosterone.

How it's diagnosed — and why a number alone isn't enough

Low testosterone is confirmed with a blood test, but the number is only meaningful alongside your symptoms. Levels fluctuate across the day and cycle, and reference ranges vary between laboratories, so a good doctor interprets the result in context rather than treating a single figure as the whole answer. Importantly, testing also helps rule out other causes of the same symptoms — thyroid issues, anaemia, depression — so you get to the real reason you've been feeling low, whatever it turns out to be.

How is low testosterone in women diagnosed?
Low testosterone is diagnosed with a blood test, considered alongside your symptoms. Because levels fluctuate and reference ranges vary between labs, a doctor interprets the result in context rather than relying on a number alone. If you have symptoms like low libido, fatigue and low mood, a doctor can test your levels and also rule out other causes such as thyroid problems, anaemia or depression.

What you can do

If this sounds like you, the most useful step is to see a doctor who takes women's testosterone seriously, and to ask about testing. While you're at it, the foundations that support all your hormones genuinely matter here too: eating enough (under-fuelling suppresses testosterone), strength training (which supports muscle and healthy hormones), good sleep, and managing stress. These won't "cure" a true deficiency, but they create the conditions your body needs to produce hormones well. And if treatment is appropriate, that's a conversation to have with your doctor — we look at the evidence in should women take testosterone.

To understand where testosterone fits among your other hormones, start with do women produce testosterone and estrogen vs progesterone.

About the author

Andreea Mighiu is a women's hormonal health educator and the founder of Zōē. She works alongside medical doctors to translate peer-reviewed research into clear, practical cycle education. She is an educator, not a physician — Zōē's content is designed to inform, not to replace personalised medical advice.

References

1. Low Testosterone In Women: Causes, Symptoms & Treatment. Cleveland Clinic. my.clevelandclinic.org
2. Symptoms of Low Testosterone in Women. Cleveland Clinic Health Essentials. health.clevelandclinic.org
3. Low Testosterone in Women: Symptoms, Causes, and Treatment. HealthCentral. healthcentral.com

This article is educational and not a substitute for medical advice. If you have symptoms of low testosterone, please see a doctor for proper testing and assessment.